INTRODUCTION 
The Changing Diabetes in Children (CDiC) program offering free access to insulin has led toimprovements in glycemic control in children living with type 1 diabetes in Cameroon. Despite this improvement, glycemic control is still far from the set targets.
PROCEDURE AND METHODS
We carried out a cross-sectional study over a period of 5months in seven different centres of the CDiC program with group of children living with type 1 diabetes receiving treatment free of charge.HbA1c was used to assess glycemic control. For each participant, the last value of HbA1c on a period of 6 months was considered. We analyzed data pertaining to the socio-demographic characteristics, history of diabetes, patient’s knowledge about diabetes, self monitoring of blood glucose levels and adherence to the diet prescribed. Glycemic control was considered as good when HbA1c were within the target range with respect to age as defined by ADA.Logistic regression analysis was used to identify factors associated with glycemic control.Data were analyzed using SPSS 19.0 and STATA 9.

RESULTS
A total of 95 children and adolescents (50 boys) were included in our study.The mean age was 16±3 yearwith a greater proportion of the study populationin the age group 13 to 19 years (85/95). The mean duration of diabetes was 4.1± 2.9 (1-14 years). The mean insulindoseper day was 0.79±0.32 U/kg and 68.1% of the study population received at least3 insulin injections per day. The mean HbA1c was 9.5%±2.8 and only 29.5% of the participants met their glycemic targets. Participants in high school had better glycemic control (χ2=5.59; p=0.018) and the set HbA1c targets were attained in patients on conventional insulin regimens (χ2=16.8; p<0.001). Leaving with both parents was associated with a better glycemic control but this association was not statistically significant (χ2=3.44; p=0.063). Glycemic control seems to be inversely correlated toduration of diabetes, but this was not significant (χ2= 1.49; p=0.475).
In multivariate analysis, only the conventional insulin regimen was associated with good glycemic control (OR=0.15; p=0.018). That may be explained by the residual secretion of insulin in those with shorter duration of diabetes (the majority of patients with conventional insulin regimen), but also by the less frequent blood glucose monitoring observed in this study.
CONCLUSION
Despite free access to care, only 29.5% of participants reach their glycemic targets. Conventional insulin regimen has been identified as a determinant of good glycemic control.

Glycemic control and associated factors in a group of children and adolescents living with type 1 diabetes in Cameroun